In the last post, I likened the Independent Payment Advisory Board to the Ringwraiths in Tolkien’s epic fantasy trilogy. The reader may find this humorous but consider a secret order of rule makers given autonomy by one individual, the President, with the sole purpose of implementing his agenda shielded from any question or interference and the analogy takes on a more serious nature. The fact that IPAB wields so much power with no oversight, checks or balances should strike dread into the very core of every American.

As one delves deeper into the language of the ACA, the sinister design of IPAB begins to emerge from the shadows like the black wraiths on Weathertop surrounding the poor hobbits. The writers of the ACA were not just content to make IPAB a law unto itself. They crafted the language in such a way as to allow for this regulatory board, with all its autonomy and unrestrained power, to have the potential to move from a 15-member panel to one unelected controller and finally even transferring its power over to the Secretary of Health and Human Services.

As stated in our last post, the ACA calls for 15 healthcare and financial professionals to sit on the Independent Payment Advisory Board. The President appoints them. This is where the details of the membership start to take some strange twists.

The term for a board member is two years. At the end of the term, the President may or may not choose to reappoint the member. The President is not required to fill the vacancy.

All that is required for IPAB to pass a ruling is a simple majority of the sitting members. One should pay close attention to the phrase “sitting members”. ACA does not require IPAB to maintain 15 members in order to function; in fact, the language in the ACA allows for IPAB to operate with only one member on the panel. The ACA even goes so far as to say that in the event that there are no members of IPAB capable of performing their duties the power of the panel is transferred to the Secretary of Health and Human Services.

Now couple this with what we learned in our earlier post that if IPAB is not repealed before 2017 it could never be repealed. Not only can it not be repealed but also the edicts and rulings IPAB decrees cannot be altered or challenged from any branch of the government or the people of the citizenry. Marry that with the troubling potential that this inordinate amount of power has the potential to be vested in one unelected individual. IPAB has the power, if not repealed, to rewrite the Constitution through statute, warns the Cato Institute.

But you might argue that these are simply precautionary measures.   Really? When has the government shied away from declaring an emergency or special situation? The markers have been laid and the roadway paved to a destruction of what the framers of the Affordable Care Act called “too much democracy”.

One always knew when reading Tolkien’s classic that the powers the Black Riders wielded was given to them for as long as they served the purpose of their master, which was always to bring all under his control. One has to wonder if the goal of the writers of the ACA was from the beginning to centralize all power under one authority with no avenue of challenge. Have we really gotten to this? “One health to rule them all, One health to find them. One health to bring them all and with our care we bind them.”